The “Toxic Dose” of System Problems: Why Some Injured Workers Don’t Return to Work as Expected View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2010-09

AUTHORS

Ellen MacEachen, Agnieszka Kosny, Sue Ferrier, Lori Chambers

ABSTRACT

Introduction Most workers who incur an injury on the job follow a relatively straightforward path through a workers' compensation claim, recovery and return to work. However, a minority of compensation claims is prolonged and can be disproportionately costly. We conducted this qualitative study in order to gain an understanding of systemic, process-related problems affecting injured workers who had failed to return to work as expected. Method A total of 69 in-depth interviews were conducted with injured workers with complex and extended workers' compensation claims and with return-to-work (RTW) providers such as health care providers, insurers, legal advisors, and workplaces. The study was based in Ontario, Canada. A modified grounded theory analysis led to the identification of common mechanisms in RTW problems. Results We identify problems with return to work and extended workers' compensation claims in dysfunctions in organizational dynamics across RTW systems including the workplace, healthcare, vocational rehabilitation and workers' compensation. These system problems are difficult to identify because they appear as relatively mundane and bureaucratic. These appeared to have damaging effects on workers in the form of a 'toxic dose' affecting the worker beyond the initial injury. Conclusions Worker's problems with extended claims were linked to RTW policies that did not easily accommodate conflict or power imbalances among RTW parties and by social relations and processes that impeded communication about RTW situations and problems. Avenues for intervention are located in a shift to a critical lens to RTW process that addresses differences of knowledge, resources, and interests among different parties. More... »

PAGES

349-366

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10926-010-9229-5

DOI

http://dx.doi.org/10.1007/s10926-010-9229-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1006071058

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/20140752


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